Provider Demographics
NPI:1679535090
Name:FRIGIOLA, MICHAEL S (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:FRIGIOLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:110 SHAFER DR
Mailing Address - Street 2:UNIT 101
Mailing Address - City:BRODHEADSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18322-7154
Mailing Address - Country:US
Mailing Address - Phone:570-992-7800
Mailing Address - Fax:570-992-0494
Practice Address - Street 1:110 SHAFER DR
Practice Address - Street 2:UNIT 101
Practice Address - City:BRODHEADSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18322-7154
Practice Address - Country:US
Practice Address - Phone:570-992-7800
Practice Address - Fax:570-992-0494
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2018-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PADC1701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11581698OtherCAQH
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PA5802962OtherGHI
PA000012812OtherHIGHMARK BLUE CROSS
PA50004880OtherCAPITAL
PA7637449OtherCIGNA
PA0005284070OtherAETNA HEALTH MGMT, LLC
PA50004880OtherCAPITAL BLUE CROSS
PA000012812OtherBLUECARE PPO
PA2327552830OtherHORIZON BLUE CROSS OF NJ
PA9206993OtherPHCS
PA810228OtherFIRST PRIORITY HEALTH